Provider Demographics
NPI:1851641740
Name:CAMILLONE, VALERIE (RN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:CAMILLONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TYLER PL
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5151
Mailing Address - Country:US
Mailing Address - Phone:845-783-6783
Mailing Address - Fax:
Practice Address - Street 1:252 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2178
Practice Address - Country:US
Practice Address - Phone:845-294-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1652071163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse